Are You Nurse Jackie or Nurse Zoey?

[Nurse Beth]

I resisted watching Showtime's Nurse Jackie for a very long time. I'm not really a TV series person. Too much commitment. Plus I don't have Showtime. And past medical shows have usually disappointed.

But recently I watched my first episode of Nurse Jackie on Netflix. Within 2 weeks I had binge watched all seven seasons. I found the show so addictive and the storyline so compelling that I couldn't wait to watch each following episode. I'm still processing it and analyzing why it had such a hold on me.

Nurse Jackie is set in the emergency department of All Saints Hospital in New York city. The main character, Jackie, is an ED nurse, as is her perky protege, Zoey.

I got hooked because the main characters are nurses, the storyline is compelling, and Nurse Jackie herself is a train wreck. Edie Falco does such a phenomenal job of being Nurse Jackie that I feel as if I know her, that we could work side by side next shift. Or maybe I was hooked because of the secret vicarious thrill I got when Jackie mouths off to administrators and doctors (with good reason, mind you).

Categorized as a comedy/drama, it's a dark comedy and more drama than comedy. Warning- it's not PG. Not for everyone and not a feel-good Hallmark type series. (There's way more sex going on in that ED than any ED I've ever worked in).

The show is really about drug addiction. Jackie is a top performing ED nurse...and also a pill-popping addict. At first, no one knows except for Eddie, the Pharmacist, who supplies Jackie with pain pills and who incidentally is also having an affair with her.

As time goes on, Jackie's drug use increases and her world starts spinning out of control. Colleagues at work begin to suspect she is using. Fentanyl patches go missing. Narcotic counts are off. At home, Jackie's husband, Kevin, divorces her while their two daughters are hurt by her unpredictable behavior and begin to act out. The story goes on to show the high cost of addiction.

As soon as it aired back in 2009, the show was instantly controversial. Some nursing associations protested that a show featuring a nurse doing many of the truly shocking and harmful things Jackie does should be taken off the air.

But there's no denying Nurse Jackie is much more realistic than most medical shows involving nurses. It shows a new doctor who misdiagnoses a patient, despite Jackie's warning. As a result, the patient dies. There's trauma and drama in every episode, craziness that only ED nurses know too well. There's short-staffing and frequent flyers.

Drug use aside, Jackie is a committed clinician whose passion is helping patients. Then there's Zoey. Zoey follows Jackie everywhere, a newbie soaking in everything. You fall in love with charming Zoey and admire Jackie while being horrified at her behavior- the behavior of a user.

Personality-wise, there's a version of a Nurse Jackie and a Nurse Zoey on every nursing unit.

Nurse Jackie

Nurse Jackie is a drug addict who steals your heart. A sociopath and a saint. Nurse Jackie breaks the rules, she's irreverent and a rogue nurse at times...but only when it helps patients. On one episode, she performs an emergency needle decompression of a tension pneumothorax, saving the life of a cab driver. Completely out of nursing scope of practice, but there was no doctor available, and Jackie saved his life. What would you do?

She rules her ED. She's witty and willful. Bossy and biting. Cynical and compassionate.

Tough with a heart, she cares about each of her patients and fights for what they need.

She has zero work-life balance. A nurse to the core, her entire identity is based on being a nurse. She once said "if I'm not a nurse...I'm no one. I'm nothing." Sad. Outspoken and mouthy, she's brutally honest (except when she's lying :).

The Nurse Jackie on most every unit? They are the ultimate pro, the gruff charge nurse, the nurse everyone respects and looks up to. They even intimidate doctors.

Nurse Zoey

Nurse Zoey, Jackie's protege, is soft and self-effacing. She wears kitty scrubs. Sweet and spunky, she lacks Jackie's sharp edges. She's adorably quirky and in addition to starting her nursing career, she is moving out of her parent's house and dating a paramedic she met at All Saint's.

Unlike Jackie, who rarely filters herself, Zoey chooses her words carefully and tactfully. She is honest and sensitive. Nurse Zoey is becoming an excellent ED nurse in her own right under Jackie's tutelage but doesn't yet know how good she is.

Zoey is a best friend to Jackie to the end. She's loyal, supportive and refuses to believe anything negative about Jackie, her hero.

Is Nurse Zoey really just a younger Nurse Jackie? Idealistic and inexperienced?

Are you a Nurse Jackie or a Nurse Zoey? No doubt you, like most of us, are a complex person. Maybe you are a mix of both, a strong nurse with frailties.

And maybe that's one of the points of the show's writers.

[Nurse Beth, MSN]

And I learned the hard way, to never say

"never".

Amen.

[Nurse Beth, MSN]

Can't I be Carol or Haleh from ER? :)

Ummm...(thinking...)... OK!! :)

[Nurse Beth, MSN]

As a nursing student, are they both portraying nurses accurately Via the media?

Yes. And no. It's exaggerated and sexed-up to make good TV, but based on reality.

[SmilingBluEyes]

In "recovery" is good. Those who chose not to do so over and over again . . . well, there has to come a time to say "never" with people who will only hurt you.

I'm involved with a family right now where both parents are meth users, their adult children are meth users, and there are 5 little kids in the home. From toddler to 11 year old. CPS is involved. It is heartbreaking to walk into that home and see the bedroom door closed because the adult kids are smoking meth while the little kids play in the living room. One of the nurses broke down after a visit and admitted she wanted to take the kids out to her car and take them home with her. One of the hardest things we've had to do is work with that family.

I respect your words and your kind intentions, and get what you are trying to say, but you admit biases still. And, further, it's not YOUR family, so it's not the same. Sorry, it's just not the same at all.

As an OB nurse I saw dozens and dozens of situations like that. I know how that is. I had a hard bias against drug abusers because of what I saw....so I get it. But....

Having it happen to me in a personal way, changed my whole outlook.

[nurseinthezoo]

I couldn't get past the first episode. Now, Breaking Bad....

[SmilingBluEyes]

And no, no nurse or doctor is portrayed completely accurately on a tv drama.

[Spidey's mom, ADN, BSN, RN]

I respect your words and your kind intentions, and get what you are trying to say, but you admit biases still. And, further, it's not YOUR family, so it's not the same. Sorry, it's just not the same at all.

As an OB nurse I saw dozens and dozens of situations like that. I know how that is. I had a hard bias against drug abusers because of what I saw....so I get it. But....

Having it happen to me in a personal way, changed my whole outlook.

The example I gave was not my family.

But all three of my siblings are meth users. All three have messed up their kids although a few of them have managed to rise above it all and in the end, make good choices not to follow in the footsteps of their parents. One did not though and he was a meth-head and alcoholic who was involved in a drunk driving accident where he suffered a traumatic brain injury and is most likely going to be very disabled for the rest of his life. He's the youngest child of one sister who routinely used drugs, slept with a multitude of men including one man who spent time in prison for being a child molester, and was physically abusive to her kids. Trying to find placement for him has been a nightmare because he is a Medi-cal patient and locally the rehab places only take one or two Medi-cal patients a month. So there is a waiting list. It is a mess. Another young man was a meth head as well and he was in an accident a few months after that where he was driving at an excessive speed at night, headlights off, going the wrong way on the freeway and he crashed head-on with another car, killing an elderly lady and himself.

I could go on and on. My family is mired in this issue. I've had to "divorce" myself from much of it due to years and years of promises to get clean and then not doing so. I do still have relationships with my nieces and nephews because I think there may still be hope. But my siblings . . . I'd have to see something almost miraculous to trust them again.

Because of my real life experiences and my admitted biases . . . I just can't stomach watching a show about an addict.

All of that personal experience started a long time ago which is why when I started nursing school 21 years ago and was asked the question about bias . . . I recognize it when I think it and don't act on it with patients.

Unless of course someone gets violent . . . we have had to discharge a meth user for destroying a CADD pump full of Dilaudid. There are lines that cannot be crossed. You can't take "never" completely off the table or you might be sending a hospice nurse (or other nurse) into an unsafe situation.

I'm trying to be realistic. I'm not without compassion. But sometimes life just hits you in the head with truly ugly circumstances.

Back in the beginning of my nursing career I probably veered towards being a "Zoey" . . . not anymore.

[SmilingBluEyes]

Thanks for sharing, Steph. I hear where you are coming from. I cannot share more really, but I get where you are coming from. Each one's experience with drug addicts in the family must be quite different.

that said....

I would be Zoey in about 15 years.

[Spidey's mom, ADN, BSN, RN]

Can't I be Carol or Haleh from ER? :)

I'd choose Carol . . .married to Dr. Ross. Not George Clooney . . .Dr. Ross!

[DowntheRiver]

The example I gave was not my family.

But all three of my siblings are meth users. All three have messed up their kids although a few of them have managed to rise above it all and in the end, make good choices not to follow in the footsteps of their parents. One did not though and he was a meth-head and alcoholic who was involved in a drunk driving accident where he suffered a traumatic brain injury and is most likely going to be very disabled for the rest of his life. He's the youngest child of one sister who routinely used drugs, slept with a multitude of men including one man who spent time in prison for being a child molester, and was physically abusive to her kids. Trying to find placement for him has been a nightmare because he is a Medi-cal patient and locally the rehab places only take one or two Medi-cal patients a month. So there is a waiting list. It is a mess. Another young man was a meth head as well and he was in an accident a few months after that where he was driving at an excessive speed at night, headlights off, going the wrong way on the freeway and he crashed head-on with another car, killing an elderly lady and himself.

I could go on and on. My family is mired in this issue. I've had to "divorce" myself from much of it due to years and years of promises to get clean and then not doing so. I do still have relationships with my nieces and nephews because I think there may still be hope. But my siblings . . . I'd have to see something almost miraculous to trust them again.

Because of my real life experiences and my admitted biases . . . I just can't stomach watching a show about an addict.

All of that personal experience started a long time ago which is why when I started nursing school 21 years ago and was asked the question about bias . . . I recognize it when I think it and don't act on it with patients.

Unless of course someone gets violent . . . we have had to discharge a meth user for destroying a CADD pump full of Dilaudid. There are lines that cannot be crossed. You can't take "never" completely off the table or you might be sending a hospice nurse (or other nurse) into an unsafe situation.

I'm trying to be realistic. I'm not without compassion. But sometimes life just hits you in the head with truly ugly circumstances.

Back in the beginning of my nursing career I probably veered towards being a "Zoey" . . . not anymore.

My husband's family has the addiction gene, and it is difficult to talk about. Only a few of my closest friends know about it because they hide it so well.

My MIL: Alcoholic (1 1/2 bottles A DAY) with CHF, A-fib, and a Pacemaker taking blood thinners.

My BIL: Habitual weed smoker (not a problem, I support marijuana use) who smokes every 2 hours. If he doesn't, he gets cranky and throws a tempter tantrum and will leave. He also has used mushrooms, benzos, and cocaine in the past. Currently hits up hospitals for pain meds for his "gluten allergy stomachaches" and has been cut off from most local ERs other than true emergencies.

My MIL's brother: Does every drug under the sun - weed, heroin, crack, cocaine, meth - you get the picture. My grandma (not mind, but I called her that because I had none) took care of him in her home. He would demand to stay there. Up until the day she died (peacefully, I might add, in her sleep of natural causes at 82) she was cleaning his bongs and used needles he had strewn throughout her condo.

My MIL's youngest sister: Had CHF. Did too many drugs (mostly marijuana, cocaine, and speed) in her youth and continued to do so up until her death at 51 two years ago from CHF

My MIL's oldest sister: Had MS. Addict when she was younger but turned her life around when she found out she had MS. Died at age 41 due to complications from MS.

My FIL: Functioning alcoholic. 2 bottles of wine a day. Always there to pour my MIL a drink.

My FIL's brother: Functioning alcoholic.

My husband: Doesn't drink except once in a blue moon. Literally, once a month if that. Definitely no drugs, although not opposed to marijuana if it were legal.

My in-laws are multi-millionaires so this is the best kept secret. Interventions don't work - nobody cares. There's so much more to this story but it felt good to get that off my chest. You'd never know by looking at us - two college educated professionals with good careers who a responsible.

[Spidey's mom, ADN, BSN, RN]

Thanks for sharing, Steph. I hear where you are coming from. I cannot share more really, but I get where you are coming from. Each one's experience with drug addicts in the family must be quite different.

that said....

I would be Zoey in about 15 years.

Kudos to you!

I'm hoping in the next few years to focus on medical missions. I don't want to get old . . .but look forward to retiring from hospital nursing.

I'm hoping that might push me towards being a "Zoey" again.

Right now, I'm (admittedly) jaded.

[SmilingBluEyes]

Steph I want so badly to go on medical mission......your trips to Vietnam inspire me. Can I come too????